It is crucial to continually expand your knowledge and stay updated with the latest advancements in ultrasound imaging.
This CPD article aims to provide an overview of the ultrasound features of testicular torsion. By recognising the key ultrasound findings associated with the condition, sonographers can play a pivotal role in aiding accurate diagnosis and timely intervention.
This article will outline six key points followed by five reflection points to enhance your expertise in detecting testicular torsion through ultrasound imaging.
Six key points
1.Testicular torsion is a medical emergency that requires prompt diagnosis and treatment. It occurs when the spermatic cord, which supplies blood to the testis, twists. This twist cuts off the blood supply to the testis, which can lead to testicular infarction and necrosis if not treated promptly.
2.Ultrasound is a valuable tool for the diagnosis of testicular torsion. The following are some of the ultrasound features that may be seen in acute testicular torsion:
- Increased size of the testis and epididymis.
- Homogeneous echotexture of the testis.
- Absent or decreased blood flow to the testis on colour Doppler.
- Whirlpool sign, which is a twisting of the spermatic cord.
- Reactive hydrocele, which is a collection of fluid around the testis.
3.Colour Doppler is helpful for assessing blood flow to the testis.
4.The presence of a reactive hydrocele is a supportive finding for testicular torsion.
5.The absence of blood flow to the testis on colour Doppler is a highly suggestive finding of testicular torsion.
6.The ultrasound features of acute testicular torsion are more obvious than those of intermittent testicular torsion. In intermittent testicular torsion, the ultrasound findings may be more subtle. The testis may appear normal or show only mild changes, such as increased size or a heterogeneous echotexture. Colour Doppler may show decreased blood flow to the testis, but this finding may not be present all the time.
Reflection prompts
- How would you assess a patient with suspected testicular torsion?
- What are the ultrasound features of acute testicular torsion?
- What are the ultrasound features of intermittent testicular torsion?
- How can colour Doppler be used to assess blood flow to the testis?
- What are the other imaging modalities that can be used to diagnose testicular torsion?
Further reading/references
Bandarkar, A. Blask, A. (2018) Testicular torsion with preserved flow: key sonographic features and value-added approach to diagnosis. Pediatric Radiology. 48 (5): 735-744. doi:10.1007/s00247-018-4093-0.
Modi, R. (2020) Testicular torsion imaging. Medscape https://emedicine.medscape.com/article/381204-overview
Radiopaedia (2023) Testicular torsion. https://radiopaedia.org/articles/testicular-torsion?lang=gb
Testicular torsion with preserved flow: key sonographic features and value-added approach to diagnosis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5895684/
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